Congress Ought To Dismantle The Healthcare Deep State

The Center for Medicare and Medicaid Innovation (CMMI) has come under scrutiny in recent months, with calls for its elimination growing louder. This agency, created under Obamacare, was intended to design and test new payment structures to reduce taxpayer spending and improve patient care. However, its track record has been marred by failures and budget overruns.

One senior Department of Government Efficiency (DOGE) staffer is reportedly trying to shield CMMI from mass layoffs and budget cuts, but many believe that the agency should be cut or even eliminated entirely. Over the past decade and a half, CMMI has not delivered on its promises, instead increasing the financial burden on taxpayers with little benefit to patients or providers.

With projections showing that CMMI could increase net federal spending by $1.3 billion over the next decade, there are calls for the Trump administration, the newly confirmed head of the Centers for Medicare and Medicaid Services Dr. Mehmet Oz, and Congress to take action. By zeroing out the agency’s budget, the funds saved could be redirected to other priorities.

Recent announcements by the Centers for Medicare and Medicaid Services to discontinue four CMMI payment models due to cost overruns and disappointing performance further highlight the agency’s shortcomings. Only four out of 49 payment models developed by CMMI over its first decade met the agency’s criteria for expansion, with the majority failing to reduce healthcare spending or improve patient outcomes.

The biggest concern with CMMI is not just its failure to achieve its goals, but its unprecedented authority to implement sweeping changes to Medicare and Medicaid. Instead of conducting small-scale tests as envisioned by Congress, CMMI has imposed nationwide mandatory payment models on healthcare providers and patients, often without sufficient evidence of their effectiveness.

One of the most notorious examples of CMMI’s overreach was a proposed change to Medicare Part B reimbursement for medicines in 2016, which would have had significant impacts on oncology clinics and patients. While this plan was eventually abandoned, the support for CMMI as a tool for unilaterally changing the healthcare system remains strong among some politicians.

It is clear that major reforms are needed for Medicare and Medicaid, but these reforms should be driven by Congress, not by unelected bureaucrats at CMMI. Republicans are now calling for the elimination of CMMI to prevent further wasteful spending and ensure that healthcare policy decisions are made through the appropriate legislative channels. It is time to put an end to one of Obamacare’s failed experiments and prioritize accountability and transparency in healthcare policymaking.